Muaj Kev Tshawb Fawb Txog Kev Noj Qab Haus Huv rau cov neeg mob uas mob raum mob

Mob raum mob (CKD) yog ib yam kab mob uas muaj ntau tshaj 10.8%. Cov neeg tuag siab yog vim muaj kev loj hlob ntawm cov kab mob raum thiab nws cov teeb meem, tshwj xeeb tshaj yog kev noj cov protein-zog. Cov khoom noj khoom haus tuaj yeem cuam tshuam txog kev mob raum thiab nws cov teeb meem. Cov neeg mob CKD kawm "noj", muaj teeb meem tsawg dua, ncua kev ua haujlwm ntawm lub raum, thiab nyob deb ntawm uremia.

Nyem rau Cistanche rau mob raum

Qhov "noj" ntawm cov neeg mob CKD txawv ntawm ib tus neeg mus rau lwm tus, nyob ntawm qhov kwv yees glomeruli filtration rate (eGFR), hom kab mob raum (proteinuric lossis non-proteinuric), thiab seb puas muaj lwm yam kab mob (xws li ntshav qab zib, ntshav siab, plawv tsis ua hauj lwm). Rau cov neeg mob CKD feem ntau, kev noj zaub mov zoo tshaj plaws zoo ib yam li qhov kawg ntawm kev kho mob ntshav siab, uas yog, cov khoom noj uas tsis tshua muaj sodium nplua nuj nyob rau hauv txiv hmab txiv ntoo, zaub, taum, ntses, nqaij qaib, thiab tag nrho cov nplej.

1. Kev hloov pauv kev noj haus tsis pom zoo rau cov neeg mob CKD theem 1-2 [eGFR Ntau dua lossis sib npaug li 60mL/(min·1.73m2)]. Lawv cov lus pom zoo txog kev noj zaub mov zoo ib yam li cov neeg siv khoom.

2. Rau feem ntau cov neeg mob uas muaj CKD theem 3-4 nrog eGFR<60 mL/(min·1.73 m2) and not on dialysis, the following dietary guidelines are recommended:

Kev noj zaub mov txhua hnub yog 0.8 g / kg. Kev noj cov protein tsawg heev [<0.6 g/(kg·d)] is not recommended. For patients with eGFR <60 mL/(min·1.73 m2) and without nephrotic syndrome, it is recommended to limit daily protein intake to 0.8 g/kg. Nutritional studies on patients with reduced eGFR suggest that reducing protein intake to 0.6 g/(kg·d) is safe [5-9], but very low protein diets are associated with increased long-term mortality [10]. For patients with CKD, mild protein restriction is generally well tolerated, does not cause malnutrition, and can avoid metabolic acidosis. We do not restrict protein intake in patients with nephrotic syndrome (24-hour proteinuria ≥3.5 g; serum albumin <30 g/L). The safety of a low-protein diet in nephrotic syndrome is unclear. Diets rich in plant-based protein may be beneficial for patients with CKD. Such diets may reduce proteinuria, reduce CKD and slow CKD progression, reduce the production of uremic toxins, reduce phosphorus intake, reduce endogenous acid production, and may reduce the risk of death

Cov zaub mov muaj zaub ntau.

Sodium kom tsawg sib txawv nrog rau tus kheej cov yam ntxwv kho mob. Rau cov neeg mob ntshav siab, ntim ntau dhau, lossis proteinuria, kev noj cov sodium<2 g/d [ie, 5 g/d of salt (NaCl)] is recommended. For selected CKD patients with eGFR <60 mL/(min·1.73 m2) and hypertension, volume overload, or increased protein excretion, sodium intake of <2 g/d (5 g/d of salt) is recommended. For patients with decreased eGFR but no hypertension, volume overload, or increased protein excretion, the approach is not clear. For most patients, mild sodium restriction of 2.3 g/d (5.75 g/d of salt) is usually recommended. However, there is one exception, namely the occasional sodium-wasting CKD patient. It is not recommended to reduce sodium intake to <1.5g/d (i.e., salt <3g/d). In addition, very low sodium intake is associated with increased mortality. The benefits of salt restriction may include: lowering blood pressure; delaying the progression of kidney disease to end-stage renal disease; and improving cardiovascular outcomes.

Kev noj cov poov tshuaj yuav tsum tau ua raws li cov ntshav cov poov tshuaj. Yog tias cov poov tshuaj ntau npaum li qub, kev noj zaub mov potassium tsis txwv. Yog tias muaj cov poov tshuaj ntau, kev noj zaub mov potassium yuav tsum raug txwv. Feem ntau, txwv tsis pub potassium tsis tsim nyog kom txog thaum eGFR poob rau<30mL/(min·1.73m2). However, there are individual differences between different patients. Some patients with high eGFR values who are taking angiotensin-converting enzyme inhibitors/angiotensin II receptor antagonists need potassium restriction to maintain normal serum potassium levels. For patients with stage 3-4 CKD, that is, eGFR of 30-59mL/(min·1.73m2), potassium intake is 2-4g/d, and it is recommended that patients in earlier stages of CKD do not restrict potassium. A high potassium diet for these patients can reduce the rate of eGFR decline in CKD patients. Other benefits of a high potassium diet in the general population include lower systolic blood pressure, lower risk of stroke, and increased bone density. However, the association between potassium intake and CKD progression and death in CKD patients remains controversial; the CRIC study report showed that those with higher potassium intake had a higher risk of CKD progression, but not all-cause mortality. The study analysis found that higher potassium intake was associated with a lower risk of all-cause mortality, but not with renal failure.

Qee tus kws kho mob tau teeb tsa lub hom phiaj tus nqi rau tag nrho cov calcium kom tsawg (nrog rau cov khoom noj khoom haus thiab tshuaj) ntawm tsawg dua lossis sib npaug li 1.5g / d, thaum lwm tus nyiam lub hom phiaj nruj dua li tsawg dua lossis sib npaug rau 1.0g /d. Cov lus qhia pom zoo kom tag nrho cov calcium kom tsawg (cov khoom noj khoom haus thiab tshuaj) txwv rau 0.8-1.0g/d rau cov neeg laus uas muaj theem 3-4 CKD uas tsis yog noj active vitamin D analogs. Ntxiv 2-4g / d ntawm calcium nyob rau hauv cov neeg mob uas muaj CKD siab tuaj yeem ua rau txo qis cov tshuaj hormones parathyroid. Txawm li cas los xij, kev tswj hwm ntawm calcium uas muaj phosphate binders rau cov neeg mob hemodialysis tuaj yeem ua rau muaj kev nce hauv vascular calcification, nrog rau cov calcium ntau nyob rau hauv cov ntaub so ntswg, ua rau metastatic calcification.

Txawm tias muaj cov phosphorus hauv cov ntshav, qhov siab tshaj plaws ntawm phosphorus yog 0.8-1 g/d; Qhov kev noj haus phosphorus no yuav tsum yog los ntawm cov khoom noj uas muaj txiaj ntsig zoo, xws li nqaij thiab qe. Nws tsis paub meej tias kev txwv tsis pub noj zaub mov tuaj yeem hloov pauv cov ntshav phosphorus hauv cov neeg mob uas tsis yog mob ntshav qab zib CKD. Rau cov neeg mob uas muaj ntshav phosphorus thiab PTH qib, kev noj zaub mov phosphorus tsis txwv. Hauv cov pej xeem thiab cov neeg mob uas muaj CKD, cov ntshav phosphorus ntau dua yog txuam nrog kev pheej hmoo ntawm cov hlab plawv. Inorganic phosphates yog bioavailable ntau tshaj li cov organic phosphates, yog li cov chaw nplua nuj nyob rau hauv inorganic phosphates, xws li cov zaub mov ua tiav, yuav tsum tau zam thaum twg los tau. Organic phosphates (piv txwv li, los ntawm cov khoom noj uas tsis tau ua tiav) yuav tsum tau hydrolyzed los ntawm txoj hnyuv enzymatic ua ntej lawv tuaj yeem nqus tau. Nyob rau hauv sib piv, cov khoom noj uas nplua nuj nyob rau hauv nkag tau yooj yim absorbable inorganic phosphates (xws li preservatives nyob rau hauv cov txheej txheem los yog npaj zaub mov) ua rau ntau phosphorus absorbed. Kev noj haus phosphate load yog ze ze rau cov ntsiab lus protein. Raws li tau hais los saum toj no, kev siv cov nroj tsuag raws li cov proteins yuav muaj txiaj ntsig zoo hauv kev tswj cov phosphorus load. Phosphorus los ntawm cov nroj tsuag muaj qhov tsawg tshaj plaws bioavailability, nrog rau bioavailability ntawm phosphorus nyob rau hauv cereals tsuas yog 50%.

Qhov siab tshaj plaws calorie kom tsawg yog 25-35 kcal/(kg·d). Kev noj cov rog yuav tsum raug txwv kom tsawg dua 30% ntawm calorie ntau ntau txhua hnub, nrog rau cov roj saturated tau txwv tsawg dua 10% ntawm calorie kom tsawg. Hauv cov neeg mob uas muaj CKD, kev rog rog yog txuam nrog qhov tshwm sim thiab kev loj hlob ntawm cov kab mob plawv thiab kev tuag.

Kev noj haus fiber ntau yog 25-34 g/d. Kev noj zaub mov fiber ntau yog cov tsis-digestible carbohydrate thiab lignin. Qhov zoo tshaj plaws ntawm cov khoom noj muaj fiber ntau muaj xws li taum, txiv ntoo, txiv hmab txiv ntoo, thiab cov nplej tag nrho. Cov txheej txheem kev noj haus rau cov neeg nyob hauv pom zoo kom noj fiber ntau txhua hnub ntawm 14 g / 1000 kcal, nrog rau qhov siab tshaj plaws txhua hnub ntawm 34 g rau cov txiv neej thiab 28 g rau cov poj niam. Cov lus pom zoo saum toj no kev noj zaub mov fiber ntau yog ua raws li ntau qhov kev tshawb fawb soj ntsuam qhia tias kev noj zaub mov fiber ntau muaj kev tiv thaiv kab mob plawv, ntshav qab zib, mob qog noj ntshav, thiab tag nrho cov neeg tuag. Raws li cov ntaub ntawv uas twb muaj lawm thiab cov pov thawj tsis ncaj los ntawm cov pej xeem, kev noj fiber ntau yuav muaj kev tiv thaiv tiv thaiv CKD kev loj hlob thiab kev tuag, thiab CKD cov pej xeem yuav tsum tau txhawb kom noj fiber ntau. Vim muaj cov poov tshuaj ntau hauv cov txiv hmab txiv ntoo thiab zaub, ntau tus neeg mob CKD thiab cov neeg mob lim ntshav tau qhia kom zam cov zaub mov no. Qhov no tuaj yeem ua rau muaj kev noj zaub mov tsis zoo hauv cov neeg CKD. Txawm li cas los xij, nws muaj peev xwm haus tau cov txiv hmab txiv ntoo uas tsis muaj poov tshuaj thiab zaub hauv qhov nruab nrab.

Hauv luv luv, CKD cov neeg mob uas tau paub txog kev noj zaub mov zoo tuaj yeem pab txo qis kev loj hlob ntawm CKD thiab txhim kho lawv cov kev mob tshwm sim. CKD cov neeg mob uas ntsib teeb meem hauv kev tswj kev noj zaub mov tuaj yeem sab laj nrog kws kho mob nephrologist lossis kws tshaj lij kev noj zaub mov.

Cistanche kho mob raum li cas?

Cistancheyog ib hom tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho ntau yam mob, suav nrograumkab mob. Nws yog muab los ntawm qhuav stems ntawmCistanchedeserticola, ib tsob nroj nyob rau hauv cov suab puam ntawm Tuam Tshoj thiab Mongolia. Lub ntsiab active Cheebtsam ntawm cistanche yogphenylethanoidglycosides, echinacoside cov tshuaj, thiabacteoside, uas tau pom tias muaj txiaj ntsig zoo rau lub raum kev noj qab haus huv.

Kab mob raum, tseem hu ua kab mob raum, hais txog ib yam mob uas lub raum ua haujlwm tsis zoo. Qhov no tuaj yeem ua rau muaj cov khoom pov tseg thiab cov co toxins hauv lub cev, ua rau muaj ntau yam tsos mob thiab teeb meem. Cistanche tuaj yeem pab kho mob raum ase los ntawm ntau lub tswv yim.

Ua ntej, cistanche tau pom tias muaj cov nyhuv diuretic, txhais tau tias nws tuaj yeem ua rau cov zis ntau ntxiv thiab pab tshem tawm cov khoom pov tseg ntawm lub cev. Qhov no tuaj yeem pab txo lub nra ntawm lub raum thiab tiv thaiv kev tsim cov co toxins. Los ntawm kev txhawb nqa diuresis, cistanche kuj tseem tuaj yeem pab txo qis ntshav siab, ib qho teeb meem ntawm cov kab mob raum.

Ntxiv mus, cistanche tau pom tias muaj cov teebmeem antioxidant. Kev ntxhov siab oxidative, tshwm sim los ntawm qhov tsis sib xws ntawm kev tsim cov dawb radicals thiab lub cev tiv thaiv antioxidant, ua lub luag haujlwm tseem ceeb hauv kev mob raum. ies pab neutralize dawb radicals thiab txo Oxidative kev nyuaj siab, yog li tiv thaiv lub raum los ntawm kev puas tsuaj. Cov phenylethanoid glycosides pom hauv cistanche tau tshwj xeeb hauv kev tshem tawm cov dawb radicals thiab inhibiting lipid peroxidation.

Tsis tas li ntawd, cistanche tau pom tias muaj cov tshuaj tiv thaiv kab mob. Kev mob yog lwm yam tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm cov kab mob raum. Cistanche's anti-inflammatory zog pab txo qhov tsim ntawm pro-inflammatory cytokines thiab inhibit qhov kev ua ntawm txoj kev yuav tsum tau rau o, yog li alleviating o nyob rau hauv lub raum.

Tsis tas li ntawd, cistanche tau pom tias muaj cov teebmeem immunomodulatory. Hauv kab mob raum, lub cev tiv thaiv kab mob tuaj yeem ua rau tsis zoo, ua rau muaj kev mob ntau dhau thiab cov ntaub so ntswg puas. Cistanche pab tswj lub cev tiv thaiv kab mob los ntawm kev hloov kho kev tsim khoom thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob, xws li T hlwb thiab macrophages. Txoj cai tiv thaiv kab mob no pab txo qhov mob thiab tiv thaiv kev puas tsuaj ntxiv rau lub raum.

Ntxiv mus, cistanche tau pom los txhim kho lub raum kev ua haujlwm los ntawm kev txhawb nqa kev tsim kho ntawm lub raum hlab nrog cov hlwb. Lub raum tubular epithelial hlwb ua lub luag haujlwm tseem ceeb hauv kev pom thiab rov nqus cov khoom pov tseg thiab electrolytes. Hauv kab mob raum, cov hlwb no tuaj yeem raug puas tsuaj, ua rau lub raum ua haujlwm puas. Cistanche lub peev xwm los txhawb kev tsim kho ntawm cov hlwb no pab kho lub raum kom zoo thiab txhim kho lub raum tag nrho.

Ntxiv nrog rau cov kev cuam tshuam ncaj qha rau lub raum, cistanche tau pom tias muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev hauv lub cev. Txoj hauv kev zoo rau kev noj qab haus huv no tseem ceeb tshwj xeeb hauv cov kab mob raum, vim tias tus mob feem ntau cuam tshuam rau ntau lub cev thiab lub cev. che tau pom tias muaj kev tiv thaiv rau lub siab, lub plawv, thiab cov hlab ntsha, uas feem ntau cuam tshuam los ntawm kab mob raum. Los ntawm kev txhawb nqa kev noj qab haus huv ntawm cov kabmob no, cistanche pab txhim kho lub raum tag nrho thiab tiv thaiv kev mob ntxiv.

Hauv kev xaus, cistanche yog cov tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho mob raum. Nws cov active Cheebtsam muaj diuretic, antioxidant, anti-inflammatory, immunomodulatory, thiab regenerative teebmeem, uas pab txhim kho lub raum ua haujlwm thiab tiv thaiv ob lub raum los ntawm kev puas tsuaj ntxiv. , cistanche muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev, ua rau nws txoj hauv kev zoo rau kev kho mob raum.